Within- and between therapist variability in movement and physiological synchrony and its effects on symptom change

The predictive power of movement and electrodermal activity (EDA) synchrony has been demonstrated in various studies. Although most studies have examined each synchrony modality separately, a growing interest in the simultaneous investigation of multiple modalities has emerged. Previous research has demonstrated the importance of disentangling within and between-dyad effects, however within and between-therapist effects have yet to be investigated. The aim of the present study was to test whether movement and EDA synchrony (measured both within and between therapists) predict across-session symptom change in two types of interventions (emotion-focused vs. cognitive). The results are based on 990 session segments of 90 clients with test anxiety who were treated with a six-session treatment program by 22 therapists, treating 3-15 clients each. Movement synchrony (on the basis of motion energy analysis (MEA) values) and EDA synchrony were quantified using cross-correlations. Symptom severity was assessed before each session using the state test anxiety measure. Movement and EDA synchrony correlated negatively (-0.19, p < .001). Moreover, higher movement synchrony as well as an interaction between movement and EDA synchrony was significantly associated with symptom improvement within, but not between therapists. In addition, an interaction between EDA synchrony and cognitive (versus emotion-focused) interventions was significantly associated with symptom improvement. These results provide initial evidence that therapists' average levels of synchrony may matter less than how synchronous they are with a specific client.